Healthcare Provider Details

I. General information

NPI: 1669728820
Provider Name (Legal Business Name): LEE TCM HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2012
Last Update Date: 07/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

293 GROVE ST FL 1
JERSEY CITY NJ
07302-3602
US

IV. Provider business mailing address

215 N 2ND ST
HARRISON NJ
07029-2547
US

V. Phone/Fax

Practice location:
  • Phone: 201-915-0710
  • Fax:
Mailing address:
  • Phone: 973-482-1530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number25MZ00041300
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number26BT00387300
License Number StateNJ

VIII. Authorized Official

Name: DR. WEIPING LI
Title or Position: PRESIDENT
Credential:
Phone: 973-482-1530